Shots or Not?The Plague, the Flu, and You

(OMNS, October 27, 2009) Swine flu. Bird flu. The media has everyone worrying about epidemics and pandemics. Yet there is nothing said about one of the great communicable diseases of all time: the plague. The Black Death. No, it is not extinct. There are new cases of plague in the United States every year, totaling over 400 cases since 1950.

Why isn't your doctor urging you to get one? Do you know anyone who has had a plague vaccination? Then why is there no plague epidemic? And why is vaccination supposedly the only way to stop a flu epidemic?

One proffered explanation is that the diseases are dissimilar, because influenza is viral, and plague is bacterial. But tetanus is bacterial, and we aggressively vaccinate against that. Indeed, the CDC http://www.cdc.gov/ncird/dbd.html specifies a considerable number of Vaccine Preventable Diseases http://www.cdc.gov/ncird/dbd.html#meningvpd which are bacterial. These include, among others: anthrax, bacterial meningitis, diphtheria, Haemophilus influenzae serotype b, and, of course, pertussis (whooping cough).

Plague is not even on the CDC's list. Wait a minute! The Black Death, the disease that killed at least a quarter of Europe, hasn't even made the list of Vaccine Preventable Diseases?

Worldwide, there are over 2,000 cases, and hundreds of deaths, every year from the plague. In the United States, human plague cases average about 10 to 15 per year.
http://www.dhpe.org/infect/plague.html Most cases are in the Southwest. http://www.cdc.gov/ncidod/dvbid/plague/plagwest.htm CDC states that "persons who have regular contact with wild rodents or their fleas" in areas in which plague has occurred should be vaccinated. That's right, it isn't just rats that carry the fleas that carry the plague. Squirrels, mice, rabbits, coyotes, woodchucks, cats and dogs all carry fleas. Fleas are found everywhere. Then why isn't plague everywhere?

One explanation is that plague is climate related. This map shows plague distribution in the US: http://www.cdc.gov/ncidod/dvbid/plague/plagwest.htm If incidence were related merely to the heat of the day, we might expect a fair share of plague cases in Florida, Georgia, Louisiana, and Alabama. But there aren't. If plague is temperature-dependent, it is a confusing illness to say the least: how come almost all USA cases are in the warm, dry Southwest and yet plague decimated Europe in the 1300s? Most of Europe is a lot cooler than the American southwest. Indeed, too warm a climate may actually stop the spread of plague. http://www.reuters.com/article/environmentNews/idUSL24636220080902

Perhaps plague does not spread because disease-carrying insects don't migrate very much. You wish. Insects spread rather rapidly. The Japanese beetle is an example. First discovered in the US in 1916, and seemingly limited to a one-half square mile area, in less than five years it had spread to 213 square miles of New Jersey. http://www.mosquito.rutgers.edu/jb.htm. In far less than a human lifetime, these insects took over twenty states, from Maine to Montana to South Carolina. Insects are everywhere. That does not exclude fleas.

Unfortunately, rats have spread everywhere, too. No major city, town or farm is free of them.

What is striking about the plague is that it is still around and practically no one gets it. One must keep in mind that this disease killed 50 million people. Eventually, the great Black Death epidemics ended. Somehow. The epidemics were not stopped by killing every flea, every rodent or every house pet. The epidemics were not stopped by antibiotics, nor were the epidemics stopped by mass vaccination. Neither were available.

So if you, and the entire population of the USA, are not vaccinated against the plague, why doesn't it spread now in 2009 the way it spread in the past, killing at least one in four?

Generally, improved sanitation and improved nutrition are credited with such a victory.

If these work with plague, they might make a rather big impact on the flu.

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